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Pregnancy Characteristics and Women’s Cardiovascular Health

By Abigail Fraser, Janet M. Catov, Deborah A. Lawlor, and Janet W. Rich-Edwards

This is one of 26 chapters published in the Handbook of Life Course Health Development.   Abstract: Growing evidence indicates that women with a history of common pregnancy complications, including fetal growth restriction and preterm delivery (often combined as low birth weight), hypertensive disorders of pregnancy, and gestational diabetes are at increased risk for cardiovascular disease later in life. Here we review the associations of parity and these four pregnancy complications with cardiovascular morbidity and mortality and the role of cardiovascular risk factors before, during, and after pregnancy complications in explaining these associations. We explore the implications of these findings for research in life course health science and policy intended to …

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Maternal Obesity

By Various

The prevalence of obesity is increasing at an alarming rate, across all populations and age groups. Estimates suggest that 20% of women will be obese by 2025—a sobering statistic, particularly considering that obesity during pregnancy increases risk of adverse health outcomes to both mother and child. What’s more, obesity during pregnancy increases the risk of life-long health problems in children, including obesity, type 2 diabetes, and heart disease. This Series in The Lancet Diabetes & Endocrinology examines the growing burden of maternal obesity worldwide in terms of its impact on clinical management and intergenerational health, and highlights the need for a focus on the pre-pregnancy period, along with a whole-of-society …

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Early Developmental Conditioning of Later Health and Disease: Physiology or Pathophysiology?

By M. A. Hanson and P. D. Gluckman

Extensive experimental animal studies and epidemiological observations have shown that environmental influences during early development affect the risk of later pathophysiological processes associated with chronic, especially noncommunicable, disease (NCD). This field is recognized as the developmental origins of health and disease (DOHaD). We discuss the extent to which DOHaD represents the result of the physiological processes of developmental plasticity, which may have potential adverse consequences in terms of NCD risk later, or whether it is the manifestation of pathophysiological processes acting in early life but only becoming apparent as disease later. We argue that the evidence suggests the former, through the operation of conditioning processes induced across the normal range …

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Pregnancy Characteristics and Women’s Future Cardiovascular Health: An Underused Opportunity to Improve Women’s Health?

By Janet W. Rich-Edwards, Abigail Fraser, Deborah A. Lawlor and Janet M. Catov

Growing evidence indicates that women with a history of common pregnancy complications, including fetal growth restriction and preterm delivery (often combined as low birth weight), hypertensive disorders of pregnancy, and gestational diabetes, are at increased risk for cardiovascular disease later in life. The purpose of this paper was to review the associations of parity and these 4 pregnancy complications with cardiovascular morbidity and mortality; to review the role of cardiovascular risk factors before, during, and after pregnancy complications in explaining these associations; and to explore the implications of this emerging science for new research and policy. We systematically searched for relevant cohort and case-control studies in Medline through December 2012 …

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Childhood antecedents to adult cardiovascular disease

By Neal Halfon, Philip A. Verhoef and Alice A. Kuo

Many of the most common and costly chronic adult health conditions have their origins in childhood and adolescence. This recognition is leading to both a profound shift in our understanding about the developmental origins of diseases such as hypertension, dyslipidemia, and type 2 diabetes mellitus (DM) and a greater focus on how different risk and protective factors influence the developmental pathways that determine optimal health across the life span. Scientific breakthroughs in the basic, clinical and epidemiological sciences reveal how different stressors and exposures during what are now termed “critical” or “sensitive” periods of development can affect growth, tissue differentiation and physiologic set points that influence an individual’s response to …

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Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease

By DJ Barker, C Osmond, J Golding, D Kuh and ME Wadsworth

In national samples of 9921 10 year olds and 3259 adults in Britain systolic blood pressure was inversely related to birth weight. The association was independent of gestational age and may therefore be attributed to reduced fetal growth. This suggests that the intrauterine environment influences blood pressure during adult life. It is further evidence that the geographical differences in average blood pressure and mortality from cardiovascular disease in Britain partly reflect past differences in the intrauterine environment. Within England and Wales 10 year olds living in areas with high cardiovascular mortality were shorter and had higher resting pulse rates than those living in other areas. Their mothers were also shorter …

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